Oral health: dentures and dental implants

More than 35 million Americans have lost all of their teeth, and 178 million are missing at least one tooth. Left unmanaged, tooth loss, or edentulism, can lead to nutritional deficiencies, oral pain, and poor psychosocial functioning. The family physician may be the first clinician to discuss tooth loss as a health concern with the patient. A patient who is interested in replacing missing teeth may be a candidate for dentures, implants, or a combination of these. The patient's preferences, general health, degree of edentulism, ability to follow up regularly, smoking status, and overall oral health should be considered when the prosthodontist makes recommendations for treatment. Smoking can delay tissue healing; therefore, heavy smoking may be a contraindication to implant placement. If a patient chooses dentures, the family physician should perform regular oral examinations, because up to 70% of denture wearers are affected by denture stomatitis at some point. Poor fit, poor hygiene, nighttime wearing of removable dentures, and bacterial or candidal infections can all be identified and managed by the family physician. The physician also can reinforce proper wear and care instructions for dentures and proper care of implants.